832.10

CH-TG

§ 28 Krankenversicherungsverordnung (TG KVV) - Datenerhebung

Pflegefinanzierung - Stationäre Pflegeversorgung im Pflegeheim und Sterbehospiz

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§ 28 TG KVV · Datenerhebung

1. Die Pflegeheime sind verpflichtet, die für die Festlegung der Normkostenbeiträge und die Vergleichbarkeit der Heime notwendigen Daten kostenlos bekannt zu geben.

2. Die Pflegeheime stellen dem Amt für Gesundheit und dem Amt für Daten und Statistik die Daten gemäss Art. 59a KVG vollständig, fristgerecht und kostenlos zur Verfügung. Das Amt für Gesundheit erlässt Vorgaben zu Inhalt, Form und Terminen der Datenlieferungen. Die Kostenrechnung ist bis am 15. April des dem Geschäftsjahr folgenden Jahres dem Amt für Gesundheit einzureichen.

3. Auf Anfrage sind dem Amt für Gesundheit weitere Daten, wie Bilanz und Erfolgsrechnung, zur Überprüfung der Kostenrechnung und Kostenentwicklung sowie der wirtschaftlichen und effizienten Leistungserbringung in der erforderlichen Qualität bekannt zu geben.

4. Leistungserbringern, welche die Datenbekanntgabe verweigern, werden die Normkostenbeiträge nach vorangegangener Verwarnung um bis zu 20 % gekürzt. Die dadurch ungedeckten Kosten dürfen nicht dem Leistungsbezüger oder der Leistungsbezügerin auferlegt werden.

← § 27 TG KVV Krankenversicherungsverordnung (TG KVV) - Inhalt § 29 TG KVV →

Gerichtsentscheide zu dieser Bestimmung (44)

730.24.107 · bl (Art. 28 KVG)

Jogging Accident Not Causal for Tooth Fractures

Cited to state that the same benefits as for illness are reimbursed in health insurance.

608 2023 83 · fr (Art. 28 LAMal)

Swissmedic Drug Reimbursement Appeal Rejected Due to High Cost and Insufficient General Therapeutic Benefit

Cited in the reasoning when listing positive lists of services.

VSBES.2023.181 · so (Art. 28 KVG)

Insurer Not Obligated to Cover Third Liposuction for Lipedema Without Established Disease Value Threshold

Cited in the reasoning as a general provision for the basis of insurance benefits.

36.2021.50 · ti (Art. 28 LAMal)

Hydrocele Surgery Inpatient Coverage Appeal Denial

Cited in the reasoning section regarding the scope of covered services.

36.2021.35 · ti (art. 28 LAMal)

Insured v. Insurer: Dental Prosthesis Repair Coverage Dispute

Used to establish that in case of an accident, the insurer covers the same benefits as in case of illness.

A/745/2019 · ge (Art. 28 LAMal)

Insurer's Appeal Admissibility Regarding Restitution of Disability Benefits vs. Medical Expenses

Cited in the reasoning to establish that health insurance does not cover daily allowances in case of accident.

S2 19 3 · vs (art. 28 LAMal)

Dental Treatment Coverage Appeal Rejection

Cited in the reasoning to establish that mandatory health insurance covers costs for accident-related dental care in the same way as for illness.

36.2018.35 · ti (Art. 28 LAMal)

Insured v. Health Insurer: Denial of Coverage for Assault Injuries

Cited in the reasoning regarding the principle that mandatory health insurance covers the same costs for accidents as for sickness.

200 2016 746 · be (Art. 28 KVG)

Insurer's Right to Choose Least Expensive Effective Dental Treatment Under Social Insurance Law

Cited to establish that mandatory health insurance covers the same benefits in case of accident as in case of illness.

KV.2015.00077 · zh (Art. 28 KVG)

Health Insurer Not Liable for Orthopedic Aids Due to Disability Insurance Coordination

Cited to establish that accident insurance coverage is the same as health insurance coverage, leading to the application of the same KVG/KLV provisions.

36.2016.66 · ti (Art. 28 LAMal)

Dental Injury Coverage Denial Appeal

Cited to establish that in case of accident, the insurer covers the same benefits as in case of illness.

36.2016.12 · ti (Art. 28 LAMal)

Dental Injury During Domestic Activity Not Extraordinary Accident

Cited in the reasoning to establish that the insurer covers the same benefits in case of an accident as in case of illness.

725.2015.39 · bl (Art. 28 KVG)

Insurer's Physiotherapy Coverage Denial Overturned Due to Insufficient Investigation

States that the same benefits as for illness are covered in case of accidents, provided no accident insurance covers them.

UV.2014.44 · sg (Art. 28 KVG)

Insurer Liability for Dental Treatment Following Accident Causation Dispute

This provision establishes the scope of coverage for mandatory health insurance, which is the subject matter underlying the dispute regarding dental treatment costs.

UV.2014.44 · sg (Art. 28 KVG)

Insurance Coverage Dispute: Accidental vs. Pre-Existing Dental Injury Causation

Cited in the introductory summary (though not strictly in the dispositive orders, it is the core legal issue related to the substantive ruling on appeal outcome).